Longitudinal preventive-screening cutoffs for metabolic syndrome in adolescents.

OBJECTIVE: To detect metabolic risk factor cutoff points in adolescence for the diagnosis of metabolic syndrome that develops at the age of 17 years (MS17). DESIGN: This study adopted a 6-year design incorporating four data collection time points (TPs). Volunteers were assessed prospectively at the ages of 12, 13, 14 and 17. PARTICIPANTS: A total of 210, 204, 198 and 187 schoolchildren volunteered at the first (TP(1)=12 years old), second (TP2=13 years old), third (TP3=14 years old) and fourth (TP4=17 years old) data collection TP, respectively. MEASUREMENTS: At each data collection TP, anthropometrical, biological and lifestyle data were obtained. Identical protocols were used for each assessment conducted by the same trained investigators. RESULTS: A total of 12% of the participants were diagnosed with MS17, the majority of them being boys (P<0.05). The prevalence of the syndrome increased directly with the degree of obesity. Using body mass index (BMI), adiposity and/or aerobic fitness levels in both genders, MS17 could be correctly diagnosed as early as TP1. No such cutoff points were found for high-density lipoprotein cholesterol, triglycerides, blood pressure and fasting plasma glucose levels. CONCLUSION: With respect to the data presented, it has been established that the calculated longitudinal preventive-screening cutoffs allow successful diagnosis of metabolic syndrome in adolescents using BMI, adiposity or aerobic fitness levels in both sexes. Adoption of such pediatric guidelines may help mitigate future increase in the prevalence of metabolic syndrome.

Greek adolescents, fitness, fatness, fat intake, activity, and coronary heart disease risk.

BACKGROUND: A dramatic increase in adult mortality rates from coronary heart disease (CHD) in Greece, accompanied by increased prevalence of CHD risk factors in children, has been documented. However, there is controversy about the independent effects of certain lifestyle parameters on primary CHD risk factors. AIMS AND METHODS: To examine the association between CHD risk factors (HDL-C, LDL-C, HDL-C/TC, triglycerides, systolic and diastolic blood pressure) and lifestyle parameters (fitness, fatness, fat intake, and physical activity) in 210 12-year old Greek pupils. RESULTS: Correcting for the fixed factors of gender and maturation, analyses of covariance (ANCOVA) with backward elimination of the lifestyle covariates revealed significant associations between three CHD risk factors (HDL-C, HDL-C/TC, systolic blood pressure) and physical activity levels. In contrast, the covariates aerobic fitness, fatness and fat intake failed to reach significance with any of the CHD risk factors. CONCLUSIONS: In Greek schoolchildren, primary CHD risk factors are mainly associated with physical activity levels, independently of fitness, fatness, and/or fat intake. Prevention strategies should concentrate on enhancing physical activity early in life, if the increased prevalence of Greek adult CHD mortality is to be diminished.

National physical education curriculum: motor and cardiovascular health related fitness in Greek adolescents.

BACKGROUND: State school physical education (PE) programmes are common throughout Greece. However, it is not known if the main objectives of the Greek PE curriculum are achieved. OBJECTIVE: To assess the current national PE curriculum in relation to selected motor and cardiovascular health related fitness parameters. METHODS: A sample of 84 Greek schoolboys (mean (SD) age 13.6 (0.3) years, height 160.7 (8.6) cm, weight 50 (10.8) kg) volunteered. Forty three indicated participation only in school PE classes and habitual free play (PE group). The remaining 41 were involved in extracurricular organised physical activities in addition to school PE and habitual free play (PE+ group). The subjects underwent anthropometric, motor (flexibility, balance, standing broad jump, hand grip, sit ups, and plate tapping), and cardiovascular health related (percentage body fat, aerobic fitness, and physical activity) fitness assessments. RESULTS: Children in the PE group had inferior motor and cardiovascular health related fitness profiles compared with those in the PE+ group. Body fat (20.3 (8.8) v 13.9 (3.5); p<0.001), aerobic fitness (34.7 (3.7) v 43.9 (4.2); p<0.001), and time spent in intensive physical activity (0.2 (0.2) v 0.7 (0.3); p<0.001) showed the greatest differences between the two groups. In the pupils in the PE group, these were lower than the levels proposed to be necessary to combat future health risks. Adjustments for confounding variables showed a decrease in the significance of motor fitness, but not in cardiovascular health related parameters. CONCLUSIONS: The national PE curriculum for Greek secondary schools does not achieve the required levels of motor and cardiovascular health related fitness and should be reconsidered.